Description
The family of human papillomaviruses (HPV) includes over 100 types of viruses, including:
- HPVs at low risk of causing cancer, some of which cause condylomas;
- HPVs at high risk of causing cancer.
HPVs are spread mainly through sexual activity. People can be infected by more than one type of HPV during their lifetime. They can also be infected more than once by the same HPV. Most sexually active people will contract an HPV infection during their lifetime.
HPVs may not cause any symptoms for many years. In most cases, the immune system eliminates these infections over the course of several months or years. In some cases, if the virus remains in the body for a long time, it can cause lesions and develop into a cancer, such as cervical cancer.
The best way to protect oneself from HPV infections and prevent their complications is vaccinations through the School-based vaccination program. That is the age when the human body’s immune system reacts best. In Québec, two vaccinations against HPV infections are offered free of charge to some groups of the population.
HPV infections at low risk of causing cancer
Low-risk HPV infections do not usually cause any symptoms. Therefore, infected persons can have it without knowing it.
Condylomas
Some low-risk HPV infections are responsible for anogenital warts called condylomas. Condylomas are spread easily by any type of sexual contact (genital, oral, anal). Condoms are often not enough to fully protect the exposed areas.
Condylomas often present as small bumps, generally as lesions with a cauliflower or rooster comb appearance or, less frequently, as flat plaque-like or pigmented lesions. There can be many of them, with more on one side of the body, and their appearance can differ. They are found on the skin and mainly in areas of contact between partners:
- on the genitals (penis, scrotum, vulva, vagina or anus);
- on the mouth;
- in the throat.
They can cause itching.
Condylomas appear between three weeks and several months or even years after the HPV infection. Without treatment, they generally disappear in a few years, but can reappear after several months or years. They often reappear after a treatment. Condylomas do not present any serious health risks. They are neither cancerous nor precancerous.
When to consult a health professional
Call Info-Santé 811 or consult a health professional if you have symptoms of condylomas.
HPV infections at high risk of causing cancer
High-risk HPV infections do not generally cause any symptoms. If a person is infected by high-risk HPV, that does not mean that the person has cancer. In most cases, the immune system is able to eliminate these infections and they do not impact the person’s health.
In a minority of infected persons, some HPVs (VPH-16 and VPH-18 or others) can cause precancerous and cancerous lesions, as well as cause symptoms. For example, lesions on the cervix could cause irregular vaginal bleeding, especially after penetration, or abnormal vaginal discharge. These symptoms may appear after sex, between menstrual periods and after the start of menopause.
When to consult a health professional
Call Info-Santé 811 or consult a health professional if you have abnormal vaginal bleeding or discharge. However, these symptoms are not necessarily caused by cancer. They can be caused by another health problem.
Treatment
HPV infections at low risk of causing cancer
No treatment can completely eliminate a low-risk HPV. Certain treatments can help to alleviate or treat the symptoms caused by the infection. They can be long and do physical damage in the medium-to-long term, mainly to the skin, causing itchiness, sensitivity, pain, redness or ulcerations, even scars, among other things.
Treatments using cream can help to make the condylomas disappear more quickly. Depending on your situation, a health professional might recommend other types of treatment for you.
HPV infections at high risk of causing cancer
In most cases of high-risk HPV, the immune system eliminates the infection in a few months.
If the high-risk HPV infection persists over time, a health professional will recommend the follow-up and treatment best suited to your situation.
Complications
HPV infections at low risk of causing cancer
A low-risk HPV infection does not cause precancerous lesions of the cervix. This type of infection does not increase the risk of cervical cancer either. However, because condylomas remain for a long time, they can cause some people the following complications:
- psychosexual reactions (anxiety, impact on sexual activities, impact on self-esteem, etc.);
- development of large condylomas;
- appearance of bumps inside the larynx or respiratory tract, or on the vocal cords. This complication is rare and can particularly affect young children, adolescents and young adults.
HPV infections at high risk of causing cancer
If an infection by this type of HPV remains in the body for a long time, it can lead to the development of lesions that can turn into a form of cancer, such as:
- cervical cancer;
- anal cancer;
- vaginal cancer;
- penile cancer;
- vulvar cancer;
- throat cancer.
Progression to these cancers is rare and happens over many years, which offers time to fully treat the lesions and prevent cancer. HPVs increase the risk of infection by HIV.
Transmission
Anyone with an HPV infection, whether it is at a low or high risk of cancer, can spread the virus, even if the person has no symptoms. HPV is contagious and is spread mainly through sexual activity. Even when a condom is used, HPV can infect unprotected areas.
Sexual transmission can occur with or without penetration. It can occur during:
- oral sex (contact between the mouth and the penis, vulva, vagina or anus);
- vaginal sex (penetration of the vagina with the penis);
- anal sex (penetration of the anus with the penis);
- contact between partners’ genitals; and
- when sharing sexual items.
Rarely, an infected mother can pass on the infection to her baby during childbirth. For further information, see the Sexually transmitted and blood-borne infections (STBBIs) and pregnancy page.
Informing partners
HPVs are very contagious and may not be symptomatic for many years. Therefore, people may not know when they were infected or when they infected another person.
If you are diagnosed with an HPV infection, consult a health professional who will give you advice and direct you to the right course of treatment. You should also talk about it with your active sexual partners. They should conduct a self-exam to look for external lesions (condylomas) using a mirror. If the presence of lesions is suspected, they should consult a health professional for treatment and to find out if there are internal lesions (for example, on the cervix). The health professional will also determine whether it is relevant for partners to be vaccinated against HPV infections.
Protection and prevention
Vaccination
The best way to prevent HPV infections and their complications is through vaccination. This reduces the risk of cancers associated with HPV, including cervical cancer, vaginal cancer, vulvar cancer, anal cancer and penile cancer. In Québec, two HPV vaccines are offered for free to eligible persons. Those who are not eligible can also be vaccinated but must pay for the vaccines.
HPV vaccines have no effect on HPVs already present or the diseases and cancers associated with them. However, they do offer protection against future HPV infections.
For further information on the program and vaccines offered, see the Human papillomavirus (HPV) vaccines page.
Screening
Screening for cervical cancer, if the person is eligible for it, effectively reduces the risk of developing this cancer and dying from it. Cervical cancer, caused by a prolonged HPV infection, is, in most cases, asymptomatic. A health professional might recommend a Papanicolaou screening test (Pap test) or an HPV detection test (HPV test). There is no screening for the other cancers associated with infections at high risk of causing cancer.
Cancer screening has advantages and disadvantages. You decide whether to participate based on your values and preferences. Screening is an option but never an obligation for eligible persons. See the Cervical cancer screening page for more information.
Sexual protection
Wearing a condom is the recommended way to protect oneself against HPV. It reduces the risk of infection by HPVs when it is used:
- during any contact between the genitals;
- for the duration of any oral, vaginal or anal sex;
- for every act of sexual intercourse.
The use of a latex square to cover the vulva or anus during oral sex reduces the risk of spreading HPV. It prevents direct contact with the mouth. To make a latex square, unroll a condom, cut off the end and then cut it lengthwise.
However, the use of a condom or a latex square does not prevent the spread of HPVs through contact with uncovered infected areas, such as the vulva and scrotum. It remains important to use a condom to limit the risk of spreading HPVs and other STBBIs.
People who share sex toys can reduce the risk of spreading HPVs by covering them with a condom. They must change the condom for each partner.
Last update: November 6, 2023
